Planning modePilot mode (e.g. only available for a subset of members and/or providers)Expansion mode (e.g. passed initial pilot stage and broadening reach)Full implementation (e.g. available to all intended/applicable providers and members)

Date of Implementation

Payment reform model alignment

Shared-risk (other than bundled payment) and/or gainsharing with qualityFFS-based Shared-savings with qualityNon-FFS-based Shared-savings with qualityFFS plus pay for performanceFull capitation with qualityPartial or condition-specific capitation with qualityBundled payment with qualityFFS-based non-visit functionsNon-FFS-based non-visit functionsNon-payment for specific services associated with HACs (healthcare acquired conditions also known as hospital-acquired conditions) that were preventable or services that were unnecessaryOther (please describe below)

Type(s) of benefit and/or provider network design features that create member incentives or disincentives to support the payment reform program

Mandatory use of Centers of Excellence (COE) or higher performing providers
Financial incentives (lower premium, waived/lower co-pays) for members to use COE/higher performance providers
Financial disincentives for members to use non-COE or lower performing providers (e.g., higher co-pays, etc.)
Use of tiered/high performance or narrow networks
Objective information (e.g., performance measure results) provided on COEs to members, providing evidence of higher-quality care rendered by these providers
No active steerage
No COE or high performing providers program
Other (please describe below)

Other features

Information transparency

We report to the general public
We report to our network providers (e.g. hospitals and physicians)
We report to patients of our network providers
We do not report performance on quality measures
We report to state or community data collection processes such as all-payer claims databases (APCDs), or AF4Q sites
Other (please describe below)

Other information transparency

Evaluation and results for program

Program not evaluated yet
Program evaluation by external third party
Program evaluation by insurer
Evaluation method used pre/post
Evaluation method used matched control group
Evaluation method used randomized control trial
Other (please describe below)